Dental medicine (prophylactodontia) has for some time been increasingly studying the so-called prevention of dental illnesses such as tooth decay by employing appropriate measures or therapies in juveniles or children.
In several studies that were carried out by different teams of researchers, it was established that xylite is suitable for the prevention of tooth decay.
In addition to its well-documented effect as a non-cariogenic sweetening agent, it was possible to prove for the pentose derivative xylite, as in S. Assev/G. Rolla, "Further studies on the growth inhibition of streptococcus mutans OMZ 175 by xylitol", Acta Path. Microbiol. Immunol. Scand. 94: 102, 1986, also a cariostatic effect. More recent research has produced evidence that xylite possesses an antibacterial, or rather, a bacteriostatic effect as it inhibits the glycolysis of the bacteria. Xylite is probably ingested by bacteria which, however, are not able to utilize this monosaccharide as a source of energy or to convert it into carbohydrate. Xylite is absorbed by the fructose-PTS system and phosphorylated in this process. Xylite phosphate is toxic for the bacteria and has to be dephosporylated and expelled. Xylite prevents the metabolism of streptococcus mutans. The combination of xylite and sorbitol has a synergistic inhibitory effect on the saccharometabolism of streptococcus mutans. With regard to an anti-decay inhibitory effect, xylite is probably the best researched of the monosaccharides. WHO xylitol field studies and chewing gum studies confirm this. Reference is made to the "Collaborative WHO xylitol field studies in Hungary--Three-year caries activity in institutionalized children". Acta. Odont. Scand. 43: 327-347, 1985, as well as to P. Isokangas/J. Tiekso/P. Alanen/K. K, Makinen: "Long-term effect of xylitol chewing gum on dental caries", Community dent. Oral. Epidemiol. 17: 200-203, 1989. Further studies are known which confirm the same results.
In more recent studies it was additionally shown how, in the presence of xylite, the level of streptococcus mutans generally decreases, both in dental plaque as well as also in the saliva.
Reference is made here to E. Soderling/K. K. Makinen/C.-Y.Chen/H. R. Pape Jr./W. Loesche/P. L. Makinen: "Effect of sorbitol, xylitol and xylitol/sorbitol chewing gums on dental plaque", Caries Res. 23: 378-384, 1969.
From this it becomes clear that, in the presence of xylite, the adhesion of the streptococcus mutans bacteria (caries initiator bacteria) to the dental surface is reduced.
Therefore, these studies already clearly show that a prevention of decay in infancy in terms of a primary prevention would be desirable, which, however, is not unproblematical. Since it has been demonstrated that the retention time of xylite in the oral cavity apparently plays an important part, the active substance has to be retained in the mouth for a fairly long period of time with the aid of suitable measures.
In children of an age starting with approximately three or four years, the release of xylite is possible with the aid of chewing gums, candies, lollipops and stick candies, by the agency of which xylite is released only relatively slowly into the oral cavity over a prolonged period of time. But the prevention of decay is already meaningful when commencing from the first deciduous dentition in order to prevent a colonization with streptococcus mutans by means of a primary prevention and achieving hereby a decay-free condition.
But the handing out of chewing gums, candies, etc. is not possible if infants are involved since the same, for the most part, will swallow them at once and the active substance xylite hardly remains, or remains not at all in the oral cavity--no such thing as a prolonged retention time is possible here. To this is added the hazard of an infant asphyxiating.
According to the DE-C-81 11 33, a tranquilizing pacifier for infants is known which is constructed so as to constitute a pacifier which can be filled with a medication and from which the medicine it is filled with mixed with candies of every kind is slowly sucked out through several sucking holes provided in the teat. In this pacifier, the teat is combined with a mouth disk so as to form a sucking portion in such a way that it is possible to detach said teat by pulling so as to render its filling with the medicament possible, in which case it is also possible to attach the teat to the mouthpiece with the aid of of a threaded connection. Perforations in the teat render a removal of the medication possible during the sucking process. The perforations are not directed in such a way as to guide the flow of the medication to quite specific points of the mouth or specifically to the gingiva, for the objective intended to b e achieved with this pacifier consists exclusively in that the medication present in the pacifier interior be drawn out and absorbed by the infant.
That is why it is the object of the invention, while turning away from the reparative dental medicine in occurring cases of decay, to provide, for the primary prevention and causal therapy, a device for infants which makes a post-eruptive optimization of the enamel maturation and the pellicle maturation of the milk teeth possible, as well as providing a colonization inhibition of mutans streptococci on these teeth and with which, in adaptation to the development of the milk teeth, the pathogens leading to decay are effectively combatted in order to avoid a permanent infection.